Is it time for surgery?

At a certain point, non-surgical methods may no longer do the job. Sydney plastic surgeon Dr Darryl Hodgkinson shares his approach to surgical rejuvenation of the face.

Before and after facelift by Dr Hodgkinson

Before and after facelift by Dr Hodgkinson

As we age, there comes a time when non-surgical treatments no longer provide a satisfactory result and the necessity for surgical procedures becomes apparent to rejuvenate the face and neck. With improvements in non-invasive radiofrequency treatments such as the newest INFINI™ treatment, combined with injectible fillers, resurfacing procedures and anti-wrinkle injections this age has been pushed up to around 50 for most women and men. After that time, however, the sagging of facial tissues, facial muscles as well as the fat maldistribution which occurs with age (either excess or degeneration) and bony resorption result in the inevitable situation wherein further non-surgical procedures alone become a waste of time and money.

Typically, with the years excess skin and or fat bulges form around the eyes and brow causing the eyebrows and often the forehead as well to sag causing us to look tired or angry. The surgical solution can be eyelid surgery to the upper and lower eyelids (blepharoplasty) as necessary and in cases of more profound forehead wrinkling and eyebrow sagging and endoscopic browlift.

The sagging neck however, and lack of definition in the jaw, however, are perhaps the most common complaints as we age for both men and women. As we lose elasticity in our skin as we age we develop jowls and deeper folds especially in the naso-labial area around the mouth. I have had patients describe this to me as the “chipmunk” or “hang dog” look. To surgically correct this, there is no single solution and the surgery must be customised to address their specific ageing so as not to create a tight, plastic and operated on look. A variety of face and neck lifting techniques from full SMAS facelifting, mid-face lifting, mini or minimally invasive facelifting all can be employed. What is critical, however, is to consider Pan Facial Rejuvenation (PFR) and not forget the neck and surrounding areas.

Pan Facial Rejuvenation which addresses all areas of the ageing face as required simultaneously gives dramatic but most importantly natural results as every aesthetic unit of the face from the brow, the eyes, the face, the neck and the skin are addressed and the clock set back on all of them to reveal not a different looking but more youthful version of the patient. In fact, I encourage patients to bring in pictures of themselves from a much younger age when they felt more confident to assess the various areas of their appearance which they feel have changed.

Patients benefit psychologically, gaining not only an improvement in their appearance but also importantly in their self-image. The results speak for themselves and you can imagine that extra confidence and quality of life that naturally occur from a patient’s improved perception of themselves.

Pan Facial Rejuvenation (PFR) is not a minimal procedure; it requires careful consultation with the patient and their supporters, and one to two weeks of healing prior to social scrutiny. Our philosophy is to only provide treatments and procedures that get the patient a result. We do not use non-surgical fillers and radiofrequency on patients who will derive little or no benefit, because they need the “real thing”, namely a surgical result which only Pan Facial Rejuvenation can achieve.

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